| [Objective]To mentor the past four years the clinic had accumulated from strengthening yang method on the treatment of lumbar disc herniation medical records for the study,the discussion was made on the guiding ideas of the tutors from the treatment of lumbar disc herniation,to summarize the syndrome differentiation and prescription medication characteristics of lumbar disc herniation,deepen the theoretical understanding of lumbar disc herniation in traditional Chinese medicine,broad the traditional Chinese medicine treatment of lumbar disc herniation and improve the clinical efficacy of lumbar disc herniation.[Method]Through reading the literature,deepening the theoretical knowledge of lumbar disc herniation and current clinical research progress in traditional Chinese medicine,collected and organized the data of tutor outpatient medical records written by the warehouse public medical record system fron December 2012 to September 2017,and obtained relatively according to the inclusion and exclusion of standard vertebrae,a total of 107 cases.Took the first and last two consultations of the case,a total of 214 consultations.The frequency of frequency analysis of the basic situation,and the use of Low Back Pain Score(M-JOA)before and after treatment scores were statistically analyzed,a preliminary efficacy evaluation,analysis of symptoms,tongue and pulse,pathogenesis,medication,discussing the dialectical thoughts and law of drug administration of lumbar disc herniation from the perspective of strengthening yang method.[Result]Among the 107 cases of 214 medical records,there were 35 males and 72 females,the frequency was 32.71%and 67.29%respectively,and the rario of male to female was 1:2.05,the number of women is significantly more than men.The maximum age was 76 years old,the minimum was 21 years old,mainly distributed between 20-69 age group,30-69 age group is the most,accounting for 83.79%.In terms of clinical manifestations,the symptoms of newly diagnosed with higher frequency include low bank pain,aversion to cold,pain of legs,soreness of loins and knees,fatigue and hypodynamia,disturbed sleep at night,dry mouth,lower limb numbness,hypohidrosis,heavy sensation in limbs.The frequency was 93.46%,62.62%,42.06%,41.12%,36.45%,35.51%,34.58%,34.58%,31.78%,29.91%,28.97%.The positive symptoms of the final diagnosis,the higher reequency of disturbed sleep at night,fatigue and hypodynamia and aversion to cold,the frequency were 27.88%,26.17%,23.36%.At the final diagnosis of negative symptoms,the higher frequencies were remission of low bank pain,disappearance of low bank pain,flexion-extension unfavorable of lumber relieved,remission of heavy sensation in limbs,followed by 31.78%,26.17%,26.17%,21.50%.in terms of tongue images,the frequency of initial diagnosis of higher frequency was pink tongue,thin white tongue coating,dark tongue and teeth prints.The frequency was 67.29%,43.92%,36.44%,18.69%,17.76%.In the final diagnosis,the higher frequencies were pink tongue,white tongue coating,white greasy tongue and teeth prints followed by73.83%,63.55%,18.69%,11.21%.In terms of pulse condition,the higher,frequencies of the first diagnosis were tense pulse,thready pulse,weak pulse,floating pulse and slippery pulse,the frequency was 52.34%,34.58%,34.58%,24.43%,20.56%.The higher frequency of terminal diagnosis pulse were weak pulse,tense pulse,thready pulse,deep pulse and feeble pulse,the frequency was 39.25%,36.45%,32.71%,23.36%,21.50%.In terms of pathogenesis,yang-deficiency and qi-de ficient,cold-damp stagnation and stagnancy of qi and blood were found at higher frequency in the initial diagnosis.The frequencies were 60.75%,59.81%.29.91%.Yang-deficiency and qi-deficient,cold-damp stagnation and liver-kidney yang deficiency were higher in the final diagnosis,with38.32%,36.45%,23.36%.In terms of the main parties involved in the legi slation,strengthening yang and construction of the law and the wen tong method at the first diagnosis are mainly followed by 59.81%and 37.38%respectively.There were 40 cases of Wen Tong Fang,32 cases of strengthening yang and damping the pain Fang,14 cases of wenqian Fang,11 cases of yang strengthening and kidney essence supplementation Fang,and 7 cases of Sini Guipi Fang.At the end of the consultation,strengthening yang and construction of the law method and Wentong method,the frequency was 85.05%,13.08%,respectively,38 cases of yang strengthening and kidney essence supplementation Fang,32 cases of strengthening yang and damping the pain Fang,14 cases of Wenqian Fang,14 cases of Wentong Fang,and Sini Guipi Fang 7 cases.In terms of drugs,the more frequent drug categories were:deficiency-nourishing drugs,interior-warming drugs,relieving the exterior and bulking cold drugs,eliminating dampness drugs.The more frequently used drugs were:Zhigancao,Shengjiang,Duzhong,Yinyanghuo,Zhifupian,Yousongjie,Zhufushen,Guizhi,Xiaohuixiang,Sharen,Cangzhu,The frequencies were 98.13%?87.38%?81.78%?73.83%?71.50%?62.62%?62.62%?59.35%?46.26%?41.12%?40.65%.For efficacy evaluation,50 complete and effective JOA score tables were selected before and after treatment.According to thee valuation of the initial and final diagnosis scores,according to the efficacy evaluation criteria,clinically cured 10 cases,markedly effective in 27 cases,effective in 9 cases,invalid in 4 cases,and total effective rate 92%.The total score before treatment was 15.24±3.13,the total score after treatment was 23.44±3.45(the higher the score,the lighter the symptoms),JOA integral score and the score of each component were tested,there was a significant difference before and after treatment(P<0.01).[Conclusion]In terms of this research material,drawing the following conclusion:(1)Mentor using strengthening yang method from the treatment of lumbar disc hernia tion of the common symptoms of lumbar disc herniation include low bank pain,aversion to cold,pain of legs,soreness of loins and knees,fatigue and hypodynamia,disturbed sleep at night,dry mouth,lower limb numbness,hypohidrosis,heavy sensation in limbs;The tongue are pink tongue,thin white tongue coating,dark tongue and teeth prints;the pulse are often tense pulse,thready pulse,weak pulse,floating pulse and slippery pulse and so on.(2)The main pathogenesis of treating lumbar disc herniation from strengthening yang method is yang-deficiency and qi-deficient,cold-damp stagnation and stagnancy of qi and blood.During the treatment,there are two basic treatment methods:Wentong Fang,strength ening yang and damping the pain Fang,Wenqian Fang,Sini Guipi Fang,yang strengthening and kidney essence supplementation Fang are the main second parties.(3)According to the analysis of JOA scores before and after treatment,the tutor had a clear curative effect in treating lumbar disc herniation from strengthening yang method,and it was necessary to further explore. |
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